The New York Times, August 24, 2004 pF6(L) col 01 (6 col in)

Lowering Patients' Blood Sugar. (Health & Fitness)(VITAL SIGNS: TREATMENTS) Mary Duenwald.

Full Text: COPYRIGHT 2004 The New York Times Company

No matter what the illness, people in hospital intensive care units tend to have elevated blood sugar levels. One way to help these I.C.U. patients survive is to give them insulin to bring their blood sugar down to near normal levels, a study at Stamford Hospital in Connecticut has found.

In February 2003, the hospital's intensive care unit began a policy of treating all patients whose blood sugar levels rose above 140 milligrams per deciliter of blood. A comparison of 800 patients who were in the intensive care unit just before the policy was introduced and 800 who were admitted immediately afterward found that mortality dropped 29 percent -- representing 49 fewer deaths among the 800 patients in the second group.

The study appears in the August issue of Mayo Clinic Proceedings.

''We showed that this low-cost intervention can have a major impact in saving lives,'' said Dr. James S. Krinsley, director of critical care at the Stamford I.C.U.

Patients in both the before and after groups suffered from a variety of health problems, including traumatic injuries, pneumonia, heart attacks and gastrointestinal bleeding, Dr. Krinsley said. In such critically ill patients, stress, medications and even intravenous feeding can cause blood sugar levels to rise.

Dr. Krinsley said high blood sugar might promote problems with blood flow leading to organ failure, and might also encourage inflammation.

After the Stamford I.C.U. doctors and nurses began regulating the patients' blood sugar, the length of patient stay dropped from an average of three and two-thirds days to three and one-third. And the number of patients with kidney dysfunction fell to 3 out of 800 from 12.